急性肾绞痛的微创治疗

Minimally Invasive Treatment of Acute Renal Colic

目的：总结急性肾绞痛的微创治疗方法。方法：回顾性分析2006年1月-2014年12月笔者所在医院收治的75例急性肾绞痛患者的临床诊治过程,采用以泌尿系CT平扫＋三维重建为核心的检查方法和急诊输尿管镜为主的微创治疗。结果：75例患者中,65例患者通过CT确诊为泌尿系结石合并肾绞痛后通过急诊输尿管镜检查、扩张、留置双J管、钬激光碎石、封堵器＋钬激光碎石等不同微创手术方法解除肾绞痛,5例辅助体外碎石（ESWL）,术后住院时间3-7 d,平均4 d,术后无并发症;另5例患者鉴别诊断为腹主动脉瘤（2例）、急性胰腺炎（1例）、胆结石（1例）、肾肿瘤（1例）均给予相应及时的专科诊治。结论：泌尿系CT诊断、急诊输尿管镜治疗肾绞痛的方法具有快速、高效、安全和防止临床误诊和漏诊急腹症等诸多优点,是一种有效解除急性肾绞痛的微创治疗方法。

Objective： To summarize the minimally invasive treatment methods of acute renal colic.Method： The clinical diagnosis and treatment process of 75 cases of acute renal colic patients from January 2006 to December 2014 in our hospital were analyzed retrospectively, the urinary CT scan ＋ 3D reconstruction wss the core of the inspection method, ureteroscopic as the main minimally invasive treatment methods.Result： 75 cases of urinary calculi, 65 cases with urinary calculi complication with renal colic were diagnosed by CT, with emergency ureteroscopy, expansion, indwelling double J tube, holmium laser lithotripsy and holmium laser lithotripsy, occluder different minimally invasive operation method to relieve renal colic, 5 cases with auxiliary extracorporeal lithotripsy（ESWL）, postoperative hospitalization time was 3-7 days, average 4 days, no postoperative complications.The other 5 patients diagnosis for abdominal aortic aneurysm（2 cases）, acute pancreatitis（1 case）, stone（1 case）, renal tumor（1 case） were given corresponding treatment in time.Conclusion： The new thinking method of urinary CT diagnosis, emergency ureteroscopic minimally invasive treatment of renal colic have advantages with fasting, efficience, safety and prevention clinical misdiagnosis and missed diagnosis of acute abdomen, which is a minimally invasive method for relieving acute renal colic.